European journal of anaesthesiology · 2026
Evaluation of clinical impact of ultra fast-track versus conventional extubation in patients undergoing nonemergency cardiac surgery: 'CARDU-FAST': A randomised clinical trial.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cruces Lourdes Montero, Alcázar Manuel Carnero, Sial Rosa L Beltrao, Vizcayno Miguel López, Martín Rubén Sánchez, Camargo Daniel Pérez, Carnicer Javier Cobiella, Mercadal Laura Álvarez, Morenza Alexandra Alonso, Lacruz Fernando Reguillo, Fernández Paula Campelos, Molano María A Giraldo, Torrón Juan M Miranda, Chávez Maria B Solís, Castellanos Luis C Maroto
Аннотация
BACKGROUND: Immediate extubation in the operating theatre (Ultra Fast-Track, UFT), compared with early extubation in the intensive care unit (ICU) (Fast-Track, FT), has been proposed as a strategy to improve postoperative recovery after cardiac surgery. However, its effect on major clinical outcomes remains unclear.
OBJECTIVE: To compare the risk of a composite outcome including perioperative all-cause mortality, respiratory complications, and acute kidney injury between UFT and FT in patients undergoing major nonemergency cardiac surgery.
DESIGN: Single-centre, randomised clinical trial conducted between February 2023 and November 2024.
SETTING: A tertiary cardiovascular centre with standardised perioperative and anaesthetic management.
PARTICIPANTS: A total of 612 adult patients undergoing major cardiac surgery were randomised to UFT (n = 306) or FT (n = 306).
INTERVENTION: Patients in the UFT group were extubated in the operating theatre, whereas patients in the FT group underwent early extubation in the ICU.
MAIN OUTCOMES AND MEASURES: The primary endpoint was a composite outcome of all-cause mortality, respiratory complications (prolonged intubation >24 h, reintubation, pneumonia), and stage III acute kidney injury (AKIN III).
RESULTS: The primary composite endpoint occurred in 6.5% of patients in the UFT group and 10.1% in the FT group, with no statistically significant difference (P = 0.105). Compared with FT, UFT was associated with shorter ICU and hospital length of stay, lower rates of prolonged intubation (2.0 versus 7.5%; P = 0.001), reduced need for noninvasive ventilation (5.6 versus 11.1%; P = 0.013), fewer reoperations for bleeding (2.6 versus 6.9%; P = 0.013) and a lower incidence of postoperative low cardiac output syndrome.
CONCLUSIONS: Although UFT did not significantly reduce the primary composite outcome in the intention-to-treat (ITT) analysis, it was not associated with an increased risk of adverse events but was associated with improvements in several secondary outcomes. These findings suggest potential benefits of UFT in carefully selected cardiac surgery patients.
TRIAL REGISTRATION: Evaluation of clinical impact of UFT versus conventional extubation in patients undergoing cardiac surgery. CARDU-FAST clinical trial. ClinicalTrials.gov Identifier: NCT05706857.
OBJECTIVE: To compare the risk of a composite outcome including perioperative all-cause mortality, respiratory complications, and acute kidney injury between UFT and FT in patients undergoing major nonemergency cardiac surgery.
DESIGN: Single-centre, randomised clinical trial conducted between February 2023 and November 2024.
SETTING: A tertiary cardiovascular centre with standardised perioperative and anaesthetic management.
PARTICIPANTS: A total of 612 adult patients undergoing major cardiac surgery were randomised to UFT (n = 306) or FT (n = 306).
INTERVENTION: Patients in the UFT group were extubated in the operating theatre, whereas patients in the FT group underwent early extubation in the ICU.
MAIN OUTCOMES AND MEASURES: The primary endpoint was a composite outcome of all-cause mortality, respiratory complications (prolonged intubation >24 h, reintubation, pneumonia), and stage III acute kidney injury (AKIN III).
RESULTS: The primary composite endpoint occurred in 6.5% of patients in the UFT group and 10.1% in the FT group, with no statistically significant difference (P = 0.105). Compared with FT, UFT was associated with shorter ICU and hospital length of stay, lower rates of prolonged intubation (2.0 versus 7.5%; P = 0.001), reduced need for noninvasive ventilation (5.6 versus 11.1%; P = 0.013), fewer reoperations for bleeding (2.6 versus 6.9%; P = 0.013) and a lower incidence of postoperative low cardiac output syndrome.
CONCLUSIONS: Although UFT did not significantly reduce the primary composite outcome in the intention-to-treat (ITT) analysis, it was not associated with an increased risk of adverse events but was associated with improvements in several secondary outcomes. These findings suggest potential benefits of UFT in carefully selected cardiac surgery patients.
TRIAL REGISTRATION: Evaluation of clinical impact of UFT versus conventional extubation in patients undergoing cardiac surgery. CARDU-FAST clinical trial. ClinicalTrials.gov Identifier: NCT05706857.